Mycosis fungoides with spontaneously regressing CD30-positive tumorous lesions

Mycosis fungoides (MF) is the most common cutaneous T-cell lymphoma. We report a case in which identical T-cell clones were identified in both patch and tumour stage lesions and in which the tumorous deposits, containing CD30-positive cells, repressed spontaneously. We discuss the differential diagnosis of the tumorous lesions and the spectrum of GD30-positive proliferative T-cell disorders.     

Can past academic criteria predict students at risk of future failure?

A significant minority of medical and dental students fail their undergraduate courses. Early warning systems (EWSs) have been developed in some areas of higher education to predict 'at-risk' students at an early remedial stage. An attempt is made to develop an EWS to predict failure in the bacteriology component of the Batchelor of Dental Surgery course at Manchester Dental School. A system based on class tests and previous end-of-year performance is derived which is used to predict those students likely to fail or fall in the bottom 20-25% in their finals examination. The predictors are combined by a simple equal weights method, which is found to have the same predictive power as using multiple regression. Failure was correctly predicted in 60% of cases, at the expense of 71% false alarms. The high number of false alarms reflects the low failure rate rather than the lack of predictive information. The need for effective cross-validation of EWSs is discussed; many previous studies have not been tested on independent data.     

DNA flow-cytometric analysis in colorectal cancer: A comparison of metastasizing and non-metastasizing tumours

The most common cause of death in patients with colorectal cancer is metastatic liver disease. In order to identify patients at a high risk of developing hepatic secondaries from colorectal cancers, DNA content was measured in metastasizing colorectal primaries (Group I, n= 32) as well as in their subsequently resected liver secondaries and in sections of non-metastasizing colorectal cancers (Group II, n= 25). A modified interpretation system involving both a DNA index and percentage of cycling cells (those in S and G2 + M phases) was developed. DNA content was measured in paraffin-embedded sections by flow cytometry using internal controls (human peripheral blood mononuclear cells) and non-malignant tissue controls (19 patients with diverticular disease). In Group I there were significantly more tumours with both abnormal ploidy (aneuploid or abnormal tetraploid peak) and > 15% cycling cells compared with Group II (Chi-squared; P= 0.034). The combination of abnormal ploidy and > 15% cycling cells was superior to Dukes’ classification for identifying metastasizing tumours (Logistic Regression; P= 0.047). However, it was not possible to discriminate between the two groups using either DNA ploidy or the percentage of cycling cells alone. The metastasizing colorectal cancers exhibited similar DNA ploidy characteristics and had a similar percentage of cycling cells compared with their liver metastases. These results suggest that tumour DNA ploidy plus the percentage of cycling cells may predict the development of liver metastases and thus survival in patients with colorectal cancer.     

Individual differences in differentiation among alcohol expectancy domains

Prior research indicates that alcohol-related outcome expectancies represent important etiological factors in the understanding of alcohol use/abuse. Although current multidimensional measures assess several substantively different domains of alcohol-related outcome expectancies, there is growing evidence that they may not possess adequate levels of discriminant validity. Therefore, the present study sought to examine whether reliable between-person differences exist in the ability to differentiate among alcohol expectancy domains. The focus of the study was on three sets of intrapersonal characteristics: cognitive resources, cognitive constraints, and alcohol-related experience. Data were collected via household interviews with a random sample of 1125 adults. Multiple regression analysis revealed that higher levels of cognitive resources were associated with increasing levels of differentiation among alcohol expectancy domains. Results are discussed in terms of implications for the development of new or revised multidimensional alcohol expectancy questionnaires. Directions for future research are also discussed.     

GENETIC ANALYSIS OF TAP2 IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS FROM TWO ETHNIC GROUPS

The aim of this study was to determine whether the TAP2 (Transporterassociated with Antigen Processing 2) locus is involved in susceptibilityto systemic lupus erythematosus (SLE). We adopted the interethnicapproach to overcome problems in the analysis resulting fromlinkage disequilibrium. The TAP2 gene polymorphisms of the codonscorresponding to amino acid positions 379, 565 and 665 wereinvestigated by amplification refractory mutation system polymerasechain reaction (ARMS-PCR) in 186 patients (151 white Europeans,35 Afrocaribbeans) and 183 controls (79 white Europeans, 104Afrocaribbeans). In the European SLE patients, the frequencyof the TAP2 type V-A-TA was marginally lower compared with thecontrol group (31% vs 42%), with negative linkage disequilibriumbetween this TAP2 type and DR3 probably accounting for the difference.For the European SLE patients, we confirmed a significant associationof DR3 with disease status [odds ratio = 4.16, 95% confidenceinterval (CI), 2.08–8.39] and in the patients with DR3there was a significantly high frequency of the TAP2 type V-A-T-.In the Afrocaribbean SLE patients, any associations of diseasestatus with TAP2 phenotype were the inverse of those in theEuropean patients. Thus, in these patients the frequency ofV-A-TA was higher than in controls (46% vs 26%, OR = 2.4, 95%CI 1.01–5.74), while the frequency of V-A-T- was lower(26% vs 40%, not significant). Despite possible sampling error,the lack of a difference in TAP2 status between cases and controlswithin ethnic groups and, if anything, an inverse associationacross ethnic groups, makes it unlikely that the TAP2 polymorphismstudied here is of primary relevance to SLE susceptibility. KEY WORDS: MHC, TAP2, SLE, Interethnic